For Mental Health Awareness Month, I want to open up about my OCD. This is something I’m extremely uncomfortable doing, hence the reason I’m doing it.

“The next suitable person you’re in light conversation with, you stop suddenly in the middle of the conversation and look at the person closely and say, “What’s wrong?” You say it in a concerned way. He’ll say, “What do you mean?” You say, “Something’s wrong. I can tell. What is it?” And he’ll look stunned and say, “How did you know?” He doesn’t realize something’s always wrong, with everybody. Often more than one thing. He doesn’t know everybody’s always going around all the time with something wrong and believing they’re exerting great willpower and control to keep other people, for whom they think nothing’s ever wrong, from seeing it.”

― David Foster Wallace, The Pale King

Have you ever thought something really weird or inappropriate? Just a passing jolt of lightning that hits your consciousness, you think to yourself, “where the heck did that come from?” It might be accompanied by a little bit of anxiety, but this likely fades pretty quick, and you go about your day.

Most people probably have no idea that I struggle with OCD. I didn’t even really know that I struggled with it until recently. I don’t have to wash my hands repeatedly, or check the oven dozens of times to make sure it’s off, so it wasn’t easy for me (or others) to recognize less obvious symptoms. It’s common for OCD to go undiagnosed upwards of 17 years for most sufferers (PDF). It is also a very misunderstood disorder, perpetuated by the public’s belief that it’s about repetitive hand-washing or keeping things more organized than normal. But for a better understanding, check out the Wikipedia article on obsessions and compulsions to get an idea of what it’s really about. It has far more to do with the inability of an OCD sufferer to handle an unwanted thought than it does with organization or cleanliness.

To put it simply, OCD is mostly about intrusive thoughts (obsessions) causing anxiety, followed by a series of compulsions to try and make the anxiety go away. These compulsions get lengthier over time as their effectiveness fades, resulting in the anxiety worsening; a vicious cycle for sufferers. They can take many forms, from physical rituals to mental rumination.

For me personally, if something triggers an “obsession,” I deal with a seemingly overwhelming sense of anxiety and dread (known as spikes) that I can’t seem to kick unless I go to battle with my own mind. I try to figure out if the thoughts mean anything about me while I search for 100% certainty that they don’t (an OCD trap). After these grueling sessions, likely out of sheer mental exhaustion, I am able to go about my day. In the past, I kept these mental compulsions very private, embarrassed of how I couldn’t magically control my own thoughts. I wondered if I was slowly going crazy.

Instead of being able to shrug an intrusive thought off, here’s how my brain works:

An intrusive thought is triggered.

Instead of letting it go, I immediately need to know if the thought means anything about me.

My anxiety spikes, and my brain jumps into a compulsive routine to make the discomfort go away.

I try to reason everything out repeatedly, going in circles searching for more and more certainty. I seek out reassurance (I love a good Google search). I check to see how I’m feeling to make sure I’m “the right level” of upset by the thought (a lovely trap, that if a thought doesn’t cause me *enough* anxiety, I get panicky that I’m now accepting them as facts).

Anxiety subsides naturally – but the previous steps perpetuate the false belief that the mental compulsions solved the problem.

I experience an overwhelming desire to revisit the thought to check to see how I’m now feeling about it, which can start the process all over again.

Because of all this time spent on the thought, I have made it seem very important in my mind, perpetuating the thought’s existence, creating an infinite loop of brain activity.

I then try and avoid any and all triggers to prevent this battle from happening again (another OCD trap).

So what am I doing to work on this excessive brain activity? While there’s no “cure” for OCD, I’m currently working with a therapist who is trained in Exposure-Response Prevention (ERP), one of the most proven methods for helping lower the symptoms of OCD. It’s an exercise in facing these scary thoughts head-on and resisting the urge to go through compulsive loops to neutralize the associated anxiety. Long story short, it’s retraining my brain to understand that thoughts are just thoughts, anxiety is temporary, and no amount of compulsions are going to help the anxiety go away faster.

Some days are better than others, but overall, things are definitely improving in this process. If you’re worried about your own thoughts, I encourage you to talk to your doctor. I waited way too long to do so myself.